Month: October 2016

Bullying is a pernicious problem in the NHS. That is the stark finding from the survey we carried out earlier this year. The online survey of more than 1,500 doctors, nurses and other health workers in hospitals, primary care and community settings, found that 81% had experienced bullying and for almost half of them (44%), it is still ongoing. Close to nine out of 10 bullying victims who responded have been left with their cases unresolved.
The findings outlined the devastating impact of bullying. A third of victims said they had been pushed out of their jobs, with many developing serious mental health problems as a result, while almost three-quarters reported increased stress and panic attacks.

Respondents who have been bullied took on average 108 days off work and almost a third (31%) said they were signed-off sick. These points were further outlined in a roundup of responses received from those who got in touch with experiences of bullying.

“The culture is driven by exerting undue pressure on others to get things done. If you don’t, you are targeted and eventually you end up with stress and depression,” one NHS manager said.

Sue Covill, director of development and employment at NHS Employers, (the employers’ organisation for the NHS in England) admits the results are worrying. “Bullying is completely unacceptable and the ongoing work to tackle it is vital for all NHS organisations, leaders and staff,” she says. “To improve the working lives of our staff and deliver the best possible care to patients, we need to create supportive, positive, open and collegiate cultures in our organisations across the health system.”

My thoughts: Anyone who has been through bullying at work, or can remember times at school when they were bullied, will know it to be an isolating, debilitating and destructive experience, affecting many aspects of their well-being. The financial implications in this survey by The Guardian Healthcare Professionals Network is concerning, with so many staff off with stress. But a the heart of this report, are broken people…broken by the organisation that, that is supposed to heal.

There is a need for a for more human connection and empathy embedded in the culture. With empathy cited as the Number 1 skill of a good Leader, there is no excuse for not utilising and optimising this natural resource to combat bullying.

As someone who has been through a very defensive and bullying NHS Compliants System, I am horrified that 55% said raising a concern prompted the abuse.

Dr Anthea Mowat, chair of the British Medical Association’s representative body, says in the guardian article that the survey results should act as an urgent wake-up call to employers. “If more staff are to speak out, they must be able to raise concerns without fear of being harassed or victimised, and there need to be clear and supportive systems of reporting in place,” she says. “We need to put an end to the climate of fear that has built up in the NHS over a number of years, with those in senior positions in the NHS leading by example to make this a reality.”

Don’t let work conflicts get you down. Researchers say you have the power to resolve conflicts and heal relationships at work.

How? Empathy.

Recent studies by Gabrielle Adams and M. Ena Inesi of the London Business School, which will soon be published in theJournal of Personality and Social Psychology, reveal that using a little empathy – that is, putting yourself in someone else’s shoes — is a powerful antidote to workplace conflict.

In an interview with The New York Times, Adams says their research shows that in workplace conflict, it’s common for there to be misunderstandings between the perceived victim and the offender — the person (or persons) committing the harm or wrongdoing.

“In many cases, the transgressors did not intend a negative effect, whereas the victims tended to think that the damage was intentional. In addition, transgressors frequently felt guilty and wanted to be forgiven much more than their victims realized.”

Adams says using empathy can reduce people’s misunderstandings or “miscalibrations” of others’ intent.

“We ask victims to think about what it would be like to be the transgressor, and you reduce that miscalibration,” Adams tells the Times.

She recommends that managers and employers use — and encourage workers to use — empathy to resolve conflicts.

Of course, empathy isn’t always going to lead to workplace harmony. For example, if the offender doesn’t think that what he or she did was wrong and the “victim” offers forgiveness, it could backfire because the offender may view it as “self-righteous,” says the Times.

“Before you can even offer forgiveness, there needs to be some kind of mutual understanding of the transgression,” Adams warns.

My thoughts: The sentence that I notice most in this, is this one…“We ask victims to think about what it would be like to be the transgressor, and you reduce that miscalibration.” This is something I had to do when I had to try and understand the motivations of clinicians in the hospital that I held responsible for possible neglect of a child that later died.

It was very hard, but I had to think what it might be like to be them. I had to do this at a time when it was hard to disassociate with my own overwhelming grief. But I did it and it worked. My pursuit of the truth was not diluted in any way, but my feelings of hatred of another human being, was diluted. Information and experiences I share as part of my empathy training course.

I have had to do this many times since on much lesser issues. Sometimes I do it well, sometimes I don’t. But what stays prominent in my mind, is trying to see the other persons position and take on the event, which is a very powerful tool. This is not always a comfortable place to be. Cognitive dissonance and wanting to keep hold of our views is very strong sometimes.

You also need the other person to do that for you too and often that is not the case and recognising that and when to accept that too and often protect yourself is also an important part of emotional development. Empathy itself actually spring boards off emotional development. But, not using empathy yourself, creates a situation that can guarantee conflict. As Professor Simon Baron Cohen from Cambridge University ‘The conflict won’t stop until we empathise’

Law firms charged a record £418 million last year after pursuing cases of medical blunders against the NHS, a Mail on Sunday investigation revealed (9 October 2016).

Their inquiries also expose how law firms are apparently prepared to excessively overcharge for their services while bringing complaints against the NHS. The revelations raise fresh concerns that the NHS is being bled dry by a compensation culture driven by opportunistic firms at a time when patients face ever-increasing waiting times for operations, overcrowded wards and difficulty in getting GP appointments.

The Mail on Sunday investigation went on to say……The astonishing £418 million bill – a 43 per cent rise on the previous year – would pay for 19,000 new nurses for the NHS, or 25,000 kidney transplants. In June last year, the then Health Minister Ben Gummer promised to cap the amounts law firms charged the NHS in cases where damages were under £100,000. But new figures from the NHS Litigation Authority (NHSLA), which fights medical negligence cases, show the problem is getting worse – with some firms submitting huge fees for relatively minor matters.

Dr James Davies, Conservative MP for Vale of Clwyd and a member of the Commons Health Select Committee, said: ‘As a GP, I have direct experience of the spiralling costs of medical defence cover. ‘Patients should have legal avenues open to them for true medical negligence, but some fees are grossly inflated and morally questionable.’

Dr Davies warned: ‘The NHS faces numerous pressures and it can do without ever-increasing litigation costs. Unless this situation can be tackled, such costs risk making the NHS unsustainable.’

The new system was due to come into force this month but has been delayed after an outcry by lawyers and patients’ groups, who say fixed costs will end up denying justice to those seeking important answers.

A consultation on the proposals is due to begin soon, said a Department of Health spokeswoman.

She added: ‘Safe, compassionate care is our priority and, to achieve this, the NHS must make sure every penny counts. Some lawyers have used claims to charge excessive costs to the NHS – in some cases more than the patient receives in compensation, and this can’t be right. Proposals are under way to cap excessive legal fees in clinical negligence claims, which will reduce clinical negligence costs.’

My thoughts: As someone who has been through the NHS Complaints system following the death of a daughter and having felt a desperate and tormenting need for justice: As someone who now is committed in training to help Trusts to listen to and help…and I mean really listen to and help those bringing a complaint using empathy and emotional development, I find this article very sad. With only 5-10% of people wanting financial recompense, and with the NHS doing in so many ways a very good job, in very difficult financial circumstances, I find the extortionate charges from lawyers unethical and unnecessary. Paying for a service is fair, of course it is, as skill and expertise is being paid for. But when it is taken from a budget that aims to help us all – and once more, most of the time does, should the the amount charged be fair too?Things will go wrong, none of us will ever be perfect and questions will always need to and should be answered and emotions and grief listened to, but cultural education, change and support for all involved should be at the heart of everything.

An article by Psychology today discusses how emotional empathy is the ability to share the emotional experience of others. It’s often the driving force behind caring, compassionate behaviour. And it’s something that may be in short supply after a bad night’s sleep, according to anew study published online last month by the Journal of Psychophysiology.

Lead author Veronica Guadagni, M.Sc., a doctoral candidate at NeuroLab in the Department of Psychology at the University of Calgary, sums up the main finding this way: “If individuals describe their quality of sleep as poor—if they feel tired and not well rested—their ability to be empathic in unpleasant situations is reduced, compared to others who feel satisfied with their sleep.”

Sleep-Deprived and Empathy-Impaired

“The negative effects of sleep loss on cognitive function—and in particular, on mood and emotional processing—are well known,” says Guadagni. However, the specific effects on emotional empathy have been less well studied.

In previous research, Guadagni and her colleagues tested how going without sleep for a whole night would influence empathy. “We kept participants awake in an experimental setting and tested their emotional empathy before and after a night of sleep loss,” Guadagni says. To assess emotional empathy, the researchers asked participants to rate their responses to a standardized set of photos picturing people in emotional situations.

“We found that, after a night of total sleep deprivation, the emotional empathy responses of participants were overall blunted,” says Guadagni. This held true whether the emotional situations depicted in the photos were positive or negative. Regardless, “participants just cared less about other people’s emotions,” Guadagni says.

What the Latest Research Findings Show

The next step was to determine whether more ordinary variations in sleep quality would have a similar impact. In Guadagni’s latest study, she and her colleagues asked 34 healthy, young college students to keep a sleep journal and wear an actigraph watch (a wearable device used to assess sleep) for a week. On Day 8, the researchers tested the participants’ emotional empathy using the same type of photos as before.

“We were interested in understanding if the relationship between sleep and empathy would hold even for daily-life changes in naturally occurring sleep quality,” says Guadagni. “We found that was indeed the case.”

Although this study was small and short-term, the results are consistent with those found in recent studies by other research teams. For example:

In a study of adolescents, poor sleep quality was associated with impairments in certain aspects of emotional competence and empathy.

In a study of health care workers—including physicians, residents, nurses, lab technicians, pharmacists, and others—insomnia was related to decreased empathy, which could lead to worse outcomes for patients.

What’s the link between a good night’s sleep and emotional empathy? Guadagni believes that poor sleep quality may disrupt communication between two key regions of the brain: areas of the limbic system involved in processing emotions and areas of the prefrontal cortex dedicated to monitoring and controlling emotional responses.

“We are currently in the process of analyzing brain imaging data from a sample of 16 healthy individuals who report variable quality of sleep,” Guadagni says. “This study will be important for understanding the neurological mechanism underlying the relationship between sleep and emotional empathy in humans.”

One thing is already clear: When you’re under-rested and over-tired due to poor sleep, your ability to manage your emotions is likely to suffer. One aspect that may be diminished is your ability to share in and care about the feelings of others.